Sotsiaalkaitseministri 06.02.2015 käskkirjaga nr 17

kinnitatud Norra finantsmehhanismist 2009-2014 rahastatud

programmi“Kodune ja sooline vägivald“ kahepoolsete suhete

fondist toetuse taotlemise korraldamise ja toetuse andmise tingimuste

juhendi lisa 1

APPLICATION FORM

for applying for support from the Fund for Bilateral Relations

“Domestic and genderbasedviolence”

NorwegianFinancialMechanism 2009-2014


  1. GENERAL INFORMATION

The given form will be used in the evaluation process of projects submitted in the framework of the open call in the Fund for Bilateral Relations”, the aim of which is to facilitate and support cooperation between entities from Norway and Estonia.
All the information must be provided in English and submitted to the to the Ministry of Social Affairs of the Republic of Estonia(together with all the relevant annexes) by 30 September 2015 andat least 30 workdays before the activities are expected to begin.
All entities that have previously received funding from the programme “Domestic and Gender based violence” (i.e. they are already implementing projects funded by the Programme) are all considered as eligible applicants.Activities already included/budgeted in the projects funded from the Programme will not be supported.
Before submitting the application please read carefully the guidelines for applying for funding from the call for proposals and the criteria for evaluating applications. We also strongly encourage applicants to read the Regulation on the implementation of the Norwegian Financial Mechanism 2009-2014as well as the Guidelines for strengthened bilateral relations published the Financial Mechanism Office.
All of the above mentioned documents are available on the programme’s website at
  1. SUBMISSION DATA

Submission Format / ☐Electronically
☐On a paper carrier (1 original+1 copy)
Title of the initiative
In Estonian and in English / Click here to enter text. /
Duration (in months) / Click here to enter text.
Start Date / Click here to enter text.
End Date[1] / Click here to enter text.
SummaryIn less than 50 words
(the motivation and argumentation for the study trip / conference / workshop)
/ Click here to enter text. /
  1. APPLICANT AND OTHER COUNTERPARTS

C.1 Applicant organization
Name of organization (include abbreviation, if applicable) / Click here to enter text. /
Title of the project funded from the programme “Domestic and gender-based violence” / Click here to enter text. /
Legal status / Click here to enter text. /
Registration number / Click here to enter text. /
Address / Click here to enter text. /
Zip-code / Click here to enter text. /
City/town / Click here to enter text. /
Country / Estonia
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
Homepage / Click here to enter text. /
C.1.1 Person Authorized to Sign the Grant Agreement
First name / Click here to enter text. /
Last name / Click here to enter text. /
Position / Click here to enter text. /
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
C.1.2 Contact Person
☐ / Check here if same as C.1.1 – Person Authorized to Sign the Grant Agreement and continue without adding contact information below
First name / Click here to enter text. /
Last name / Click here to enter text. /
Position / Click here to enter text. /
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
I allow the Ministry of Social Affairs to send information and documents to the e-mail address noted above / ☐YES / ☐NO
C.2 Norwegiancounterpart/expert involved in the initiative (if applicable)
Name of organization(include abbreviation, if applicable)or expert / Click here to enter text. /
City/town / Click here to enter text. /
Country / Click here to enter text. /
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
Homepage / Click here to enter text. /
C.2.1Contact Person
☐ / Check here if same as C.1.1 – Person Authorized to Sign the Grant Agreement and continue without adding contact information below
First name / Click here to enter text. /
Last name / Click here to enter text. /
Position / Click here to enter text. /
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
C.2.3Counterpart’s/expert’srole and tasks in the initiative
Please describe the role and tasks of the partner/expert in the initiative. Explain why particularly this organization/expert is involved.
Click here to enter text. /
If in addition to the partner mentioned above, there are other entities involved with the project that qualify as partners, please provide their information as exemplified in section C.2.
[Copy information on additional partners here]
  1. The initiative

D.1 Objectives and expected outcomes.
Why is the initiative needed and how does that contribute to the objectives and implementation of the on-going project. Please describe the objectives and expected results of the initiative.
Click here to enter text.
D.2 What are the shared results that the project will achieve through bilateral cooperation?
What particular knowledge, experience, know-how and/or technology will be shared to achieve shared results?How will these activities improve knowledge and understanding in Estonia and between the partner organizations. Is there any wider effect expected as a result of advancing bilateral relations.
Click here to enter text
D.3Activities of the initiative
Please describe planned activities. Indicate duration and preliminary schedule and expected results of the activities.
Click here to enter text
D.4 Choice of participants
Please give an overview and justification on the choice of participants, their professional suitability, role and tasks in the initiative and in the project.
Click here to enter text
D.5Distribution methods of knowledge
Please describe how and to which target group are you going to deliver the knowledge, best practices and contacts acquired.
Click here to enter text
D.6 Risk Analysis
Please analyse the potential risks that may come up during the execution of the initiative and describe measures for prevention and elimination.
Click here to enter text
  1. Budget

E.1General budget of the initiative
Only those expenses that have been made during the period when the expenditures are eligible can be considered part of the overall budget. See also art 2.5.3 of the Guidelines.
Expense category / Unit of measurement (hour/person/etc.) / Unit Price / Total
  1. ...

  1. ...

  1. ...

  1. (insert additional rows as needed)

Total cost of the initiative / Click here to enter text. / €
  1. Letters of Understanding

To be completed by the person authorised to enter into legally binding commitments on behalf of the applicant
The applicant undertakes to inform theProgramme Coordinator at the Ministry of Social Affairs of all changes affecting the activities as described in this form.
The applicant allows the Department of Equality Polices at the Estonian Ministry of Social Affairs to use all data provided in this application form for the purposes of managing and evaluating the initiative submitted under the call for proposals in the Fond for Bilateral Relations.
In the event that this application is successful, the the Ministry of Social Affairs has the right to publish (online or in any other appropriate medium):
  • the name of the beneficiary of the grant (and relevant partners);
  • the amount awarded;
  • a short synopsis of the initiative.
The applicant undertakes to inform all other entities involved with the execution of the initiative of the criteria set forward in the Guidelines for applying for funding from the callofBilateral Relations Fund.
All personal data collected for the purpose of this application shall be handled in accordance with the Estonian Personal Data Application Act[2]. If at any time, the person submitting the data thinks that his/her personal information has not been handled properly, he/she has the right to turn to the Data Protection Inspectorate.
Fulllegalname / Click here to enter text.
Position / Click here to enter text.
Signature / Click here to enter text.
Date / Click here to enter text.
To be completed by the person authorised to enter into legally binding commitments on behalf of the applicant
I, the undersigned, hereby request a grant from the Norwegian Financial Mechanism 2009-2014 of programme “Domestic and gender-based violence”Click here to enter amount EURto implement the action described in this grant application.
I certify that all information contained in this application, including the description of the initiative, is correct to the best of my knowledge and am aware of the content of the annexes to the application form.
I certify that the applicant organization has the financial and managerial capability to execute the proposed project successfully.
I certify that the applicant organization is not in any of the following situations:
  1. bankrupt or being wound up, their affairs are administered by the courts, have entered into an arrangement involving creditors, have suspended business activities, are the subject of proceedings concerning those matters, or are in any analogous situation arising from a similar procedure provided for in national legislation or regulations;
  2. has been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata;
  3. has been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation, money laundering or any other illegal activity;
  4. has been in serious breach of contract or has failed to comply with following another procurement procedure or grant award procedure;
  5. if they are not in compliance with their obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the Estonian Republic.
I certify that the applicant organization or other organization and people involved with this project:
  1. are not in a situation where there is a conflict of interests[3];
  2. have not presented false information;
  3. have not applied for any funding for the same project from other grant programs, EU programs, or from the Estonian state treasury.
By signing this application form, I accept all the conditions set out in the Guidelines for Applying for Support from the Fund for Bilateral Relations.
Fulllegalname / Click here to enter text.
Position / Click here to enter text.
Signature / Click here to enter text.
Date / Click here to enter text.
We request that the application with all its annexes be sent electronically or delivered by mail to the Ministry of Social Affairs no later than Sept 30th, 2015 at 17:00 (EET).
Postal address:
Estonian Ministry of Social Affairs
Department of Equality Polices
Gonsiori 29
15027 TALLINN
E-mail:

Depending on how you submit your application, please write either as the subject of the e-mail or on the envelope “EE11 – Fund for bilateral relations”
Applications delivered by mail must be in a sealed envelope and submitted as two copies – 1 original and 1 copy. In addition, an electronic copy of the application must be submitted at
NB! When submitting the application by mail, do not staple the documents.
NB! When submitting the application electronically, keep the document in the form of a Microsoft Office Word document (.doc, .docx, .rtf, etc.)

Ministry of Social Affairs
Gonsiori 29, 15027 Tallinn

[1] Activities must end by 31 March 2016.

[2]

[3]A conflict of interest is a situation in which a relationship between an applicant and an official from the Ministry of Social Affairs and/or an evaluator may lead to a conflict between either party’s professional and private interests in which the private interests of an official or evaluator may influence the impartiality and objectivity and the responsibility related to that.